Solving baby boomers’ problem with hepatitis C

Baby boomers — Americans born between 1945 and 1965 — grew up in one of
the wealthiest, most idealistic and physically fit generations in history.

BY Katrina Burton

Jagpreet Chhatwal, along with collaborators at the University of
Pittsburgh Graduate School of Public Health and others, has predicted
that a one-time screening of baby boomers will help identify 487,000
cases of hepatitis C during the next 10 years. Such a screening, they
say, could make hepatitis C a rare disease in the next 22 years. Photo:
Eric Kayne

Today, boomers account for close to 30% of the U.S. population. As this group gets older, public health officials are examining how they have and will transform health care.

One area of concern is the hepatitis C virus, a serious liver disease transmitted through contaminated blood and blood products, often spread through shared needles or contaminated medical and body-piercing equipment.

“Baby boomers are five times as likely to have hepatitis C,” says Jagpreet Chhatwal, Ph.D., assistant professor of Health Services Research at MD Anderson. “This generational group accounts for 75% of at least 2.7 million people infected in the U.S. And at least half of those with the virus don’t know they’re infected.”

The reason baby boomers have high rates of hepatitis C is not completely understood. It’s possible that many became infected from contaminated blood and blood products before widespread screening began in 1992 and universal precautions were adopted. Because people with the disease can live for decades without symptoms, many baby boomers unknowingly live with an infection they contracted years ago.

Chhatwal says hepatitis C is responsible for more than 15,000 deaths each year in the U.S., and is the leading cause of liver cancer in the nation. Therefore, it’s more important now than ever to identify those at risk and improve access to care and treatment.

In 2012, the Centers for Disease Control and Prevention implemented guidelines for a one-time hepatitis C screening of all baby boomers with the intent to avoid major increases in liver diseases such as liver cancer, which is a risk associated with hepatitis C.

New hepatitis C drugs that are taken orally and have fewer side effects than older drugs became available in 2013. With these new drugs, treatment duration has decreased from 48 weeks to 12 weeks.

More new drugs are expected to hit the market in the near future, Chhatwal says.

In a study published in the Annals of Internal Medicine, Chhatwal, along with collaborators at the University of Pittsburgh Graduate School of Public Health and others, predicted present and future hepatitis C disease trends. They developed a mathematical model using data from more than 30 clinical trials and national surveys.

The researchers predict that a one-time screening of baby boomers will help identify 487,000 cases of hepatitis C during the next 10 years. Such a screening, they say, could make hepatitis C a rare disease in the next 22 years. Furthermore, the researchers predict a one-time universal screening of all adults will identify 933,700 hepatitis C cases. In turn, this will eliminate 161,500 liver-related deaths and 96,300 cases of liver cancer, and prevent the need for 13,900 liver transplants.

“Screening can help identity people who are infected so they can receive timely treatment,” says Chhatwal. “There are drug therapies available that can eliminate the virus before it becomes a disease and causes major liver damage, cirrhosis and liver cancer.”

Tiny, virus-sized particles released by cancer cells may be the next big
thing in the world of cancer biology. Exosomes, derived from cells and
blood serum of patients, have been shown to detect pancreatic cancer
and, possibly, breast cancer, and are also linked to increased cancer
progression and tumor growth.

MD Anderson’s expertise in cancer immunotherapy attracted the interest
of four major pharmaceutical companies, which signed three-year
collaborative agreements in early 2014 to develop new ways for the
immune system to destroy tumors.

The first experimental drug to be produced by MD Anderson’s drug
discovery and development institute will kill cancer cells in a new way
— by depriving them of the fuel necessary for growth and survival.

Since its introduction in the 1940s, the Pap test has been successfully
detecting abnormal cells in the cervix that, if left untreated, could
lead to cancer. In fact, that success has led to a 70% drop in cervical
cancer rates in the United States.

The center that provides veterinary and preclinical research services to
support MD Anderson has received new, leading-edge laboratory equipment,
thanks to a $20,000 gift from Torchy’s Tacos in Austin.

It was 1980 when Janelle Hail of Frisco, Texas, discovered a small lump
during a self-breast exam. A visit to the doctor resulted in an early
breast cancer diagnosis. The then-34-year-old mother of three feared for
her life. Today, she attributes her survival to early detection.